Clinical Practice guidelines for the use of erythropoiesis-stimulating agents (ESA: epoetin alfa, epoetin bêta, darbepoetin) in anaemic patients with cancer: 2007 update (summary report)

Isabelle Ray-Coquard; Diana Kassab-Chahmi; Nicole Casadevall; Pascal Chastagner; Christian Marchal; Perrine Marec-Bérard; Jean-Louis Misset



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Clinical Practice guidelines for the use of erythropoiesis-stimulating agents (ESA: epoetin alfa, epoetin bêta, darbepoetin) in anaemic patients with cancer: 2007 update (summary report)
Bulletin du Cancer. Volume 95, Number 4, 433-41, Avril 2008, I. Ray-Coquard et le groupe de travail SOR
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Author(s) : Isabelle Ray-Coquard, Diana Kassab-Chahmi, Nicole Casadevall, Pascal Chastagner, Christian Marchal, Perrine Marec-Bérard, Jean-Louis Misset
Summary : Beginning 1998, a working group of specialists convened by the guidelines department (Standards, Options and Recommendations: SOR) of the National French Federation of Comprehensive Cancer Centres (FNCLCC) published then regularly updated Recommendations relative to the use of ESA in anaemic patients with cancer. This article presents a short version of the Recommendations updated in 2007. Methods. This updating process is based on the methodology developed and used in the “Standards, Options: Recommendations” programme. The methodological approach combines systematic review with the judgement of a multidisciplinary group of experts. A Recommendation is a proposal of one or several clinical attitudes intended to improve cancer patient care. There are two levels of gradation for the Recommendations: Standards and Options. Their setting takes into account the organisational context of care, the particular situation of the patient and the expression of his preferences. Before publication, the RPC-SOR are re-examined by independent reviewers selected according to the same principles as the group of expert writers. Results. New data are sufficiently important to update the latest Recommendations validated in 2003. Thus, five clinical questions were updated. The resulting modifications were either major (new Options or new Standards) or minor (increased level of evidence). It should be noted that for the clinical question - use of ESA in radiotherapy - new data are not sufficient to generate modifications in the initial Recommendations which remain valid. Conclusions. Because of the important new data published on the subject between 2003 and 2007, it appears relevant to re-examine these Recommendations according to a systematic monitoring process which should be renewed in 2 years.
Keywords : guidelines, cancer, anaemia, ESA, epoetin, iron